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Effects of Constraint-Induced Therapy Versus Bilateral Arm Training on Motor Performance, Daily Functions, and Quality of Life in Stroke Survivors

School of Occupational Therapy, College of Medicine, National Taiwan University, and Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei

Ya-fen Chang, MS

Division of Occupational Therapy, Department of Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei

Ching-yi Wu, ScD, OTR

Graduate Institute of Clinical Behavioral Science and Department of Occupational Therapy, Chang Gung University, Taoyuan, cywu{at}mail.cgu.edu.tw

Yi-an Chen, MS

Department of Occupational Therapy, Yung Cheng Rehabilitation Clinic, Taipei

Background and Objective. This study investigated the relative effects of distributed constraint-induced therapy (CIT) and bilateral arm training (BAT) on motor performance, daily function, functional use of the affected arm, and quality of life in patients with hemiparetic stroke. Methods. A total of 60 patients were randomized to distributed CIT, BAT, or a control intervention of less specific but active therapy. Each group received intensive training for 2 hours/day, 5 days/week, for 3 weeks. Pretreatment and posttreatment measures included the Fugl—Meyer Assessment (FMA), Functional Independence Measure (FIM), Motor Activity Log (MAL), and Stroke Impact Scale (SIS). The proximal and distal scores of FMA were used to examine separate upper limb (UL) elements of movement. Results . The distributed CIT and BAT groups showed better performance in the overall and the distal part score of the FMA than the control group. The BAT group exhibited greater gains in the proximal part score of the FMA than the distributed CIT and control groups. Enhanced performance was found for the distributed CIT group in the MAL, the subtest of locomotion in the FIM, and certain domains of the SIS (eg, ADL/IADL). Conclusion. BAT may uniquely improve proximal UL motor impairment. In contrast, distributed CIT may produce greater functional gains for the affected UL in subjects with mild to moderate chronic hemiparesis.

Key Words: Controlled clinical trial • Stroke rehabilitation • Constraint-induced therapy • Bilateral arm training • Upper extremity • Quality of life

This version was published on June 1, 2009

Neurorehabilitation and Neural Repair, Vol. 23, No. 5, 441-448 (2009)
DOI: 10.1177/1545968308328719


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